Continua Health Alliance

“Strategic Intelligence Monitor on Personal Health Systems” Workshop – IPTS, EC April 2009

Mario Romao
Co-Chair, EU Policy WG, Continua Health Alliance Senior Manager, Healthcare Policy, Intel Corporation
Extended team: Stelios Tsintzos, Medtronic; Brigitte Piniewski, Oregon Medical Laboratories; Luis Perez, Telefonica; Christine Claus, Intel; Petra Wilson, Cisco; Vesa Pakarinen, VTT; Charles Lowe, Telehealth Solutions; Chuck Parker, Continua Health Alliance

The Continua Health Alliance Mission



• Basic life monitoring as appropriate (ADL) 3 Weight loss and fitness coaching Disease management service Family care givers 09/14/10 .Personal Telehealth PULSE OX BLOODPRESSURE CUFF IMPLANT Health & Wellness Cell Phone PEDOMETER Healthy family Digital Home PC • • • • • Weight loss Fitness Email / chat / video Appt scheduling Personal Health Records HOME AUTOMATION & CONTROL Disease Management • Vital sign monitoring (RPM) • Medication reminders and compliance • Trend analysis and alerts • Connect with family care givers FITNESS EQUIPMENT MEDICATION TRACKING Personal Health System Elderly Internet Personal Health Records Healthcare Professionals Aging Independently • An adult child helping their elderly parents age gracefully in their own home.

Promoter Members Open International 09/14/10 4 .

TSB Soluciones TTA Tyco Electronics Tynetec Ltd UnitedHealth Group University of Miami . GenerationOne..Medical International Research  Murata Manufacturing Co.l. LLC  Motorola  MIR. GlaxoSmithKline Google Inc. LAXTHA Inc. Inc.  Lifescan  Logic  LS Research. VTT Technical Research Centre of Finland Westchester Institute for Human Development Whole Health Management Zarlink Semiconductor Zensys 5 . Bluegiga Technologies Oy Boston Scientific Cambridge Consultants Ltd. Inc. LLC Honeywell HomMed LLC Hosiden Corporation Industrial Technology Research Institute Infineon Technologies INFORSON Co. AppsHub. The Scottish Centre for Telehealth Toshiba Home Appliances Corporation Toumaz Technology Limited Triage Wireless Inc. LLC  MEDCEL  MedHelp International  Medixine Oy  MedSignals  MedTech Systems Inc. Inc. Claricode.  Microlife Corporation  Midmark Corporation  Misys Healthcare Systems  Monitray. Ltd.  Neusoft Medical Systems  Nippon Telegraph and Telephone Corporation  Nitto Denko Corporation  Novo Nordisk  Nuubo (Smart Solutions Tech)  ON Semiconductor  Oregon Medical Labs  Oregon Scientific Inc.. Inc.. Ltd Hitachi. Institute for Infocomm Research Institute of Biomedical InterComponentWare. Intramed A/S KDDI Konami Sports and Life Lamprey Networks. Inc.  RMD Networks  Ryoyo Electro Corporation  Sensor Technology & Devices Ltd  Shimmer Research  SHL Telemedicine  Shorewood Packaging  Silicon and Software Systems  Smartlife Technology Ltd  Sony Electronics Inc. SpA Telecom Italia SpA Telefonica S. ETRI EuroTech. LG CNS LG Electronics Inc. Telbios.  PA Consulting Group  Pfizer  Precor Fitness  Proskauer Rose LLP  Proteus Biomedical... H3System Co. Ltd. Ltd. AT4 Wireless AT&T Mobility AViTA BiancaMed BIOSPACE Co. Capital Health Card Guard AG Cardiff University Cardiomedix Inc. Ltd. Fairbanks Scales FitLinxx Foundation for Research and Technology France Telecom R&D. Telehealth Solutions Ltd. Ltd.A. Inc.d. CSR plc CYPAK AB Cypress Semiconductor Dell Digi International Dossia Consortium Dovetail Health 09/14/10 Duodecim Medical Publications                                      Dynastream Innovations Inc. LLC Freescale Semiconductor Frontline Test Equipment Fujitsu Limited Fullpower Technologies GC Healthcare Corp. Innomed Medical Zrt. Telus Communications Company Terumo Corporation Textronics Inc. Inc. Inc. CELS.Contributors                                        Alcatel Lucent Alere Allion Test Labs. Ltd. Home Guardian. Inc. Centre for Global eHealth Innovation Cerner Corporation Chiptech Limited Christus Health Chunghwa Telecom Co. Inc. Inc.Miller School of Medicine Verizon VivoMetrics. Ltd. Computerized Screening. Ember Corporation Empirica GmbH Ericsson Nikola Tesla d. ConnectBlue AB Continuity Health Convergence Wireless.                                 Over 180 Members! Southern Nevada Wellness Stichting IMEC – Nederland Stollmann E+V GmbH STMicroelectronics TaiDoc Technology Corporation Tanita Corporation TechnoGym Tekoa Technologies Inc. American Heart Association Analog Devices Andago Ingenieria s. All Medicus Co.

Guidelines → Certification → Recognizable Logo 09/14/10 6 .

Version One Design Guidelines After two years of work from more than 175 companies around the world. Continua Health Alliance is proud to announce the formal release of its Version One Design Guidelines and the Continua Certification Program Continua Version One Guidelines 09/14/10 7 .

1st Continua Certified Product Congratulations to Nonin Medical.! 09/14/10 8 . Inc.

Version One Device Connectivity Standards Pulse Oximeter Pulse / Blood Pressure Weight Scale Glucose Meter Cardiovascular and Strength Fitness Monitor Independent Living Activity Medication Monitor 09/14/10 • 11073-10404 = Pulse Oximeter • 11073-10406 = Pulse / Heart Rate • 11073-10407 = Blood Pressure • 11073-10408 = Thermometer • 11073-10415 = Weighing Scale • 11073-10417 = Glucose • 11073-10441 = Cardiovascular Fitness Monitor • 11073-10442 = Strength Fitness Equipment • 11073-10471 = Independent Living Activity • 11073-10472 = Medication Monitor PC Personal Health System Cell Phone Bluetooth Medical Device Profile Specification Set Top Box USB Personal Healthcare Device Class Specification Aggregator 9 .

Version One Health Record Standards Healthcare Provider Disease Management Service Home-based Remote Patient Monitoring (RPM) System CDA/CCD-based Personal Health Monitoring (PHM) Specification Electronic Health Record System Labs Patient Vital Sign Devices 09/14/10 XDR Transport Specification EHR / PHR 10 .

First Public Interoperability Demonstration Harvard Medical Auditorium 10/27/08 Device Interface Heart Failure & COPD XHR Interface EHR Wireless Pulse Oximeter Telehealth Service Weighing Scale Obesity & Diabetes PHR Telehealth Service EHR Blood Pressure Monitor Telehealth 09/14/10 Service 11 .

Ecosystem Development 09/14/10 12 .

ATA.S. Policy WG U.S. Payer WG 13 .400 members participating in the various Working Groups Use Case WG Technical WG Test & Certification WG Employer HR Benefits WG Marketing WG Regulatory WG Policy Strategy WG Expert Group NHS.Working Group Structure Board Of Directors VTM Administration Executive Director Over 1. AAFP. AHA… 09/14/10 SubCommittees PR & Marketing agency Australia Policy WG EU Policy WG Japan Policy WG Latin America Policy WG U.

PHS market now and in the future: enablers and drivers HealthC Burden ost Increasing costs of the old model of health care become a national crisis 09/14/10 14 .

and the medical care costs of people with chronic diseases consumes more than 75 percent of US medical care costs (CDC) – … etc… 09/14/10 15 . LTCs account for 72 percent of all inpatient bed days. LTCs consume 69 percent of England’s primary and acute care budget (NHS England) – In 2005.PHS market now and in the future: the perfect storm • The challenge: – In Europe the number of people aged from 65 to 80 will rise by nearly 40% between 2010 and 2030. suffer from a long-term condition.4 million people. This percentage should become 25 %. – Almost half of all Americans – 133 million people in 2005 – have at least one chronic condition. 65 percent of all outpatient appointments and 52 percent of all GP appointments. including 60 percent of those over age 60. to fulfill the need in 2025. (Goudriaan et al. and by 2050 more than a quarter of the European population is expected to be over 65 years (EC. WHO) – In England 15. 2005). 12 percent of the total workforce in the Netherlands worked in the (health)care sector.

40-64% reduction in physician time for checks and 63% reduction in transport costs (Cleland et al 2005.5 million by 2016. 2003.7B in 2012 (Data Monitor. 2001. 47% reduction in risk of hospitalization. Scalvini S et al. (InMedica. 2006. representing a forecast CAGR of almost 72%. Goldberg et al.PHS market now and in the future: the potential for transformation • The area of telehealth/home health monitoring is predicted to grow very rapidly. Lee R. 6 days reduction in length of hospital admission and 65% reduction in office visits. Van Ginneken et al 2006) 09/14/10 16 . 2008) • There is increasing evidence to support the value of remote monitoring for patients with chronic diseases. 2007) • Number of telehealth subscribers worldwide will increase to 55.. from a $3B market in 2009 in North America and Europe to an estimated $7. Elsner et al. including: – – – – – – 35-56% reduction in mortality.

C. 2008) • The focus on wellness: – Poor health lifestyles dramatically increase population risk for disease.. 2008) • US Veterans Administration: over a four year period. L.PHS market now and in the future: the potential for transformation • US could generate net savings of $197 billion dollars over 25 years through telehealth-enabled monitoring of patients with CHF. COPD. and chronic skin ulcers (Litan.74% decrease in hospital admissions and 25. Edington. B.31% reduction in BDOC (Darkins et al. – The costs of waiting to intervene until after disease is present are staggering. F. 2004.2006 09/14/10 17 . more than 30. Herman et al.000 patients enrolled in the VA’s remote monitoring program showed a 19. Piniewski.2006.W.2006. diabetes. D. Wang et al.. 2008. Yen et al. – Low risk populations can remain healthy by modifying personal health behaviours.

EHR. desktop) 09/14/10 18 .PHS market now: actors • Continua membership shows across the board interest both from supply and demand sides: – – – – – – – – – – Medical devices Fitness IT Pharma Health care providers Health insurers Telecommunications Sensors Internet Applications (PHR.

evolutionary.sometimes with public incentives • Support public health and corporate wellness programs • Rewards for keeping people healthy • Greater integration among wellness. service driven offerings 09/14/10 19 .PHS market in the future • The individual / home as the hub • Convergence consumer / healthcare • Consumer health / PHRs fitness . scalable. health and social care • Best-of-breed plug and play • Increased connectivity.

wellness and ageing independently. The individual truly becomes the hub for wellness and health management.PHS market in the future: the continuum of life and care Infant Amateur Athlete Diet/Fitness Focused Worried Well Chronic Patient Acute Recovery Elderly Living Independently CONTINUUM of LIFE The Continua Health Alliance “connected health and care” vision blurs the frontiers across solutions for healthcare. CONTINUUM of CARE GIVERS New Parents Fitness Wellness Coach The Family Home Nursing Professional Doctor/NP/Nurse 09/14/10 20 .

PHS market in the future: public health and employer programs • Step 1 – – Identify & define modifiable health and standardize it across populations by referencing health to an indicator such as TCHOL/HDL Move from self-reported data to a sensor-based approach that wirelessly uploads objective data to track Lifestyle Performance Indicator responses to specific health modifying efforts Objectively monitor Lifestyle Performance Indicators to predict an individual’s trend toward disease before onset of symptoms or signs and associated costs • Step 2 • Step 3 – Pre-Disease Lifestyle Performance Indicators Triglycerides (TG) High Density Lipoproteins (HDL) TG/HDL Low Density Lipoproteins (LDL) Total Cholesterol (TCHOL) TCHOL/HDL Insulin Glucose 09/14/10 Disease Heart Disease Stroke Diabetes Alzheimer's D Kidney Failure Liver Disease Many Cancers Cognitive Decline 21 Lifestyle Burden .

PHS market in the future: disease management 09/14/10 The Innovative Care for Chronic Conditions Framework (WHO) 22 .

WHO Greater information sharing •Vital sign collection and management •Integration with: • survey results • educational content • video conferencing • Data rich health management systems • Connection to: • friends and caregivers • healthcare advice and information • Safe and friendly environment adapted from Intel 09/14/10 23 . two way communication Improved quality of care and Social connection Personal Health Systems prepared e car alth He team Co mm par u ni t tn e y rs mt oiv ated fi ron Patients and families em d ICCC.PHS market in the future: disease management Real-time.

be independent” M U U IN NT O C Connected PHS ecosystems enabling: • Basic ADL monitoring • Health information • Disease management • Social interaction • Beyond home support • Virtual residential care homes Meaningful & useful life “It would be great to maybe have an exhibition of my work sometime” Bringing healthcare home “People think that doctors can cure everythingthat’s not true” Enabling social interaction “I don’t like to be alone” Help getting care “We know the pharmacist very well. Intel 09/14/10 24 .PHS market in the future: ageing independently Feeling safe “Since I fell I’m a lot more afraid of falling” Supporting cognition “You have to challenge your mind and brain” Environments of choice “Despite my lack of mobility I can turn on garden lights with this remote control” E TH DY Supporting BO DN I physical activities M “I want to move easily. it’s easy to get my medicine” Global ageing experience project.

PHS market in the future: the coalescence of market segments Multiple providers / service oriented Wellness Management/Support Systems Weight Scale Weight Blood-Presser Cuff Fitness. nutrition. stress management… Device / Systems / Sensors Bio-metric/ Behavioral Responses Biometrics Testing Glucose Meter Cholesterol HDL/LDL Triglycerides Blood Sugar Spirometer HRA/Health Administrative Assistant BloodPressure Healthcare provider Pulse Oximeter Person Centered Resting Heart Rate Body Fat % Lung Air Volume Fitness Equipment Disease management service Wellness Center Body Fat Analyzer Information Systems Pedometer Medication Tracking PHR/PHA Gait analysis Activity Hub Classes Elderly monitoring services 09/14/10 Family care givers 25 .

Deutsche BKK – German statutory health insurers covering heart disease • Veterans Health Administration (US) – 30.000 users covering multiple diseases 09/14/10 26 .000 users. Newham.Business cases to follow-up on RPM and disease management {Not comprehensive} • England – Whole system demonstrators (three sites: Cornwall.000 users • West Lothian – Implementation of RPM covering 400 users • AOK. 6. telehealth and telecare • Northern Ireland – Implementation of RPM covering 5. Kent).

09/14/10 27 . – The implementation of telehealth is likely to require a significant change in working practice and training on its use. – There may be an initial increase in workload and transition period before it is integrated into practice and the benefits realised.Innovation models: some considerations • Telehealth – Moving past initial pilots requires the creation of a shared vision and belief in the impact of telehealth. patients and carers. identifying “super users” and early adopters to raise awareness of technology and associated benefits can help to drive innovation at all levels of the organisation. training and education support for nurses. and access to secure funding streams/reimbursement models. Additionally. – As with most new innovations champions should be appointed to ensure that projects are driven through. – It is recommended that there are change management tools developed to support this transition – There should be appropriate training and education for healthcare professionals as part of their continued professional development).

Thank You Thank you! 09/14/10 28 .

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